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{ <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810- FAX 425-257-8857-www.everettwa.org `1/ <br /> APPLICATIONS ARE ACCEPTED FROM E AM TO 4 PM `"� <br /> SITE ADDRESS: <br /> G � n� VROPENTY TAI(N PER T� <br /> G" <br /> LEGAL lor new conatruction: Short PIaVs iviaion Lot No._ (atlech copy ol laip legel deaulplion) <br /> OWNER �" .� V�• l-0 "'� Phone/E-meil ( � ' i� � D <br /> Addrese ClrylStotelZlp �I <br /> CONTRACTOR LQ W I �• �C L 8 I Llc.M L E S �✓ �✓ C � <br /> ddreee / —73�'� ��V• vtiI°�� {1' � 2t� PhonelEmall �—�-�w ' - <br /> TB E �QS, P � ,fL <br /> PhonelEmall —2 '"�� <br /> �UILDINa PlRMIT APPLICATION coNTRACr PRICE oF WORK <br /> Existing Use of Building � -�-- HEAT SOURCE: <br /> Proposed Use of Building <br /> � r Gae Iectric Othar <br /> Building lype: �Ingle Femily _D plex_Townhouse ,_Multi•Family ,Commarcial <br /> Type ol project: _Naw __Addition �Remodel _Repair_T.I._.,Sign_Sprinkler_Demolition_Changa of Uee <br /> Deac�iptiono[,Work�edditiona� pecepiovidedonfheDeck): <br /> �y���.�r J� .�-U���o-� 7� li�;�f�onL <br /> Have you�tarted working without a permlt7 _YES �NO <br /> MECMANICAL PERMIT APPLICATION PLUMdINO rlRMIT A��LICATION <br /> Type of ProJ�el: _New_Addn _Attentlon_R�p�lr Typ�ol Projeot: _INw_Addn �Ibntlon_Mpdr <br /> Show Numb�r N)ol flxtun� Show NumMr orn,n�n, <br /> FUC-air hendlin units Toilel <br /> Farced air s atems Bathtub <br /> Ges pi in Levato wash Deain <br /> Water heater Shower <br /> Gas fire lace Kitchen sink 8 die osel <br /> Gas ran e Dlshwaeher <br /> Clolhes d er Clothes waaher <br /> Ran ehood Waterhealer <br /> Exhaustlan Sink service/barlmo /etc. <br /> Heat um Backflow reventar <br /> Unit heater Urinel <br /> Boiler Drinkin Founlain <br /> Relri eration Floor drain <br /> Woodstova Greasa tra <br /> Ductin Rool drefns <br /> Other Medlcal Gae <br /> SPRINKLER I SUPPREEEION dYSTEM other: <br /> Number of Heads Other: <br /> I hereby certily Ihal I have read end e�amined thle applicetion and know Ihe same lo De lrue and corecl.All provlalone ol lawe and ordinence�poveminp <br /> this lypo ol work will be complied wilh whelher sprcified herein or nol.The pran�lnp ol e permll doea not preaume lo pive authorlty lo vlolate or uncel <br /> the p�ovislon ol any ot�er stele or local law regulatlnp conaVuctlon or the perlormence of construc�lon.That I am eulhorized�y Ihe ovmer ol�hla propaAy <br /> to peAorm tho work lor which applicallon I made end I c ply with Ihe Slale Conirac�on Lew 18.27 FCW en0 298.Y00 WAC <br /> ��.,. .�� - y�_�( <br /> OwneNAulhodzed tSignature Dale (��������� �/� <br /> � <br />